Development of a classification system for lung ultrasonographic findings in calves based on the association with cure and production outcomes.

The primary objective of this study was to determine associations between ultrasound-based classification systems (using maximum consolidations depth, number of quadrants with consolidation, and consolidation location), clinical indicators, and performance outcomes (ultrasonographic cure, ADG, and cold carcass weight [CCW]) in veal calves following oral metaphylaxis. A retrospective cohort study was conducted on 1,090 white veal calves originating from 3 Belgian veal herds. Clinical scoring and quick thoracic ultrasound (qTUS) follow-up were done by 4 experienced operators at arrival (wk 0), at the start of the first metaphylactic treatment with doxycycline (treatment initiation, wk 1), at the end of this metaphylactic treatment (short-term evaluation, wk 3) and on a long-term evaluation point (wk 10-12). Cure was defined as complete reaeration of previously consolidated lung tissue. Pathogens were identified using culture and nanopore sequencing. One week after arrival, healthy lungs (no consolidation), mild pneumonia (consolidation <1 cm), moderate pneumonia (consolidation ≥1 but <3 cm), and severe pneumonia (consolidation ≥3 cm) were identified in 46.9%, 12.4%, 21.4%, and 19.4% of calves, respectively. Short-term cure was 59.3% for calves with mild pneumonia, 50.2% for calves with moderate pneumonia, and 32.7% for calves with severe pneumonia, resulting in a total short-term cure of 45.9%. Coronavirus, respiratory syncytial virus, influenza D virus, and Mycoplasmopsis bovis were circulating during treatment. At the long-term evaluation point (wk 10-12), final cure was 59.3%, 55.8%, and 40.3% for calves with mild, moderate, and severe pneumonia at treatment initiation, respectively. Multivariable regression models indicated that different interactions between qTUS categories and number of affected quadrants were associated with short- and long-term odds of cure. Generated models resulted in 3 classification methods, either based on maximum consolidation depth, number of affected quadrants, or an integrated system of both. Calves with clinical pneumonia (Wisconsin score ≥5 and lung consolidation ≥1 cm) had decreased short-term odds to be cured after metaphylaxis compared with calves with subclinical pneumonia (Wisconsin score <5 and lung consolidation ≥1 cm; odds ratio = 0.43; 95% CI: 0.27-0.67). For calves with severe pneumonia in wk 10-12, when compared with calves in a lower qTUS category, ADG and CCW were reduced by 104 g/d (SD = 13; 95% CI: 78-130) and 7.1 kg (SD = 1.9; 95% CI: 3.4-10.9), respectively. Categorization based on maximum consolidation depth, the number of affected quadrants, or an integrated system of both has the potential to be included in an ultrasound scoring system. However, based on the practicality for recording, reporting, and follow-up, the authors recommend categorizing calves into mild, moderate, and severe pneumonia based on maximum consolidation depth measurement, referred to as qTUS score, as a practical classification system for ultrasonographic lung assessment in calves.